Lifestyle Management of Erectile Dysfunction: The Role of Cardiovascular and Concomitant Risk Factors
Section snippets
Epidemiologic Studies
How strong is the support in the epidemiologic literature for the benefit of lifestyle change, such as exercise, weight loss, or smoking cessation? Does ED in most patients respond to nondrug or lifestyle interventions, either in short-term or long-term outcomes? What related benefits can be shown for mood state and overall cardiovascular health? A number of recent epidemiologic studies have addressed these and other similar issues related to the association between ED and other cardiovascular
Intervention Studies
A recent intervention study from Naples, Italy, 14 provided a controlled, prospective study of short-term treatment effects of lifestyle modification in men with obesity-related ED. This multicenter, randomized study compared 2 years of intensive exercise and weight loss with an educational control in 110 obese men (mean BMI, 36.4) with moderate ED. Patients with overt diabetes or other CVD conditions were specifically excluded from this study. Patients in the weight loss and exercise group
Combination Treatment
Lifestyle change could potentially be recommended for patients with ED and CVD independently or in combination with PDE5-inhibitor therapy. Some investigators have suggested that PDE5-inhibitor effects might be augmented by aggressive management of common comorbidities, such as diabetes or atherosclerosis. 21 Although promising, these results require confirmation in further prospective, randomized trials.
Conclusion
Clinical guidelines for ED emphasize the need for lifestyle change and risk factor modification either before or in conjunction with PDE5 therapy. 22 Previous recommendations of the first Princeton Consensus Panel, as well as other recent guidelines from the International Consultation of Urological Diseases, have stressed the clinical benefits in managing ED for patients who achieve lifestyle change. 22, 23 The recommendations for lifestyle intervention may be of special significance for those
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Cited by (28)
The Circle of Lifestyle and Erectile Dysfunction
2015, Sexual Medicine ReviewsCitation Excerpt :ED is an independent risk factor for future CVD events; therefore, sexual function should be incorporated into CVD risk assessment for all men. Moreover, CV risk reduction potentially improves sexual function [15,82]. Early diagnosis of ED, CV assessment, and aggressive treatment of CV risk factors might contribute to prevention of acute events [83].
Sexual dysfunction in diabetes
2014, Handbook of Clinical NeurologyPrevalence of Co-morbidities in patients with erectile dysfunction
2013, Actas Urologicas EspanolasCaloric Restriction Prevents Visceral Adipose Tissue Accumulation and Maintains Erectile Function in Aging Rats
2012, Journal of Sexual MedicineCitation Excerpt :A moderate level of CR attenuated the development of adiposity and delayed the onset of ED that occurs with age in male SD rats. Although mechanisms remain to be elucidated, lifestyle modifications, including CR and exercise, are recommended in the initial intervention of both CVD and ED to elicit global improvement in cardio‐metabolic risk factors [7,8,21,22]. The present findings suggest that a threshold level of CR is required to achieve a significant reduction in adiposity, improve endothelial function of the IPA, and thereby enhance erectile function.
Multidisciplinary approach to the cardiovascular patient: The role of andrology
2012, Revista Internacional de AndrologiaMorphological and functional evidence for the contribution of the pudendal artery in aging-induced erectile dysfunction
2010, Journal of Sexual MedicineCitation Excerpt :With the expanding aging population, it has been projected that by 2025, the number of men with ED will more than double to 322 million men [3]. Further complicating ED in the aging population is the concomitant increase in morbidity related to cardiovascular and metabolic conditions such as hypertension, coronary artery disease, chronic kidney disease, diabetes, hyperlipidemia, and obesity [4–9]. During aging, impaired neural signaling, decreased androgen levels, and pathogenic vascular remodeling have all been shown to occur [10–12].